Friday, November 10, 2006

euphoria crash

i was in the ultimate euphoria the past four days.

-i found out i will get sixty sessions of PT covered next year (still = $600 in copays, but way better than 20 sessions.)

-i went to visit an orthopedic doctor (i'll call him doctor #4) at palo alto medical foundation (sports medicine is next door to neurology, so dr. chang knows all of the sports medicine doctors there) who happens to be one of the very few specialists in the country in my problem. he thoroughly went through my whole history, films, pictures from my last surgery, and checking out my knee, and disagreed with the procedure my current doctor (doctor #2) wants to do. he went into very specific details, explaining everything he thinks is wrong, and what exactly he would do to combat it. on top of that, he would give me injections post-surgery to trick my knee from growing back the tissue. i feel much more comfortable getting my fourth surgery with him, since doctor #2 spends like maybe five minutes at most looking at my knee each visit (as most of you know, i'm NO fan of the stanford "patient=barcode" system), and told me he wanted to do a certain type of surgery only because he didn't know what else to do, and was backed into a corner. this, even though another doctor (doctor #3) he sent me to get a second opinion with didn't think it was the right procedure either.

anyway, i was elated, thinking that i could finally solve my knee problems next year. doctor #4 saw some potential other problems in my knee that he would check out when going in & attacking my scar tissue problems. if those issues really exist, then it would result in surgery #5, and possibly a surgery as intrusive as another ACL reconstruction, which was the original surgery. even with this news, i was still happy because i finally found a doctor that i felt like i could trust. a doctor who listens to me. a doctor who takes the time to check my knee out. a doctor with good bedside manners. a doctor who i could get appointments with in a timely manner. a doctor who was upfront with me with the chance of success from this surgery. none of doctors 1, 2, or 3 fufilled all of those requirements.

and then yesterday, i decided to make sure the hospital doctor #4 performs surgery at is covered by my health insurance. i only checked because it's a very small hospital, only used by palo alto medical foundation. i called the hospital, and discovered they are out of network. even though the doctor is in-network, his hospital is not.

and then everything came crashing down.

to have to pay for hospital charges out of network is $$$$$ (each $ = a digit). even if i max my flexible spending account (FSA) at $3.5k, it wouldn't even be near enough to cover even half of the amount of the portion of the hospital bill i'd owe. and if i'd have to get another surgery after this? the dollars are piling up in my head. i don't want to find another doctor. i've done a lot of research online, and found that even "superstar" orthopedic doctors (like doctors 2 & 3) do not know how to treat my problem properly, and that if i really wanted to be healed, i'd definitely have to have an orthopedic surgeon who specializes in arthrofibrosis perform my surgery. i found a list of specialists, and you could count the number of doctors in the entire country on your fingers.

so here i am, in a battle again with not-so-Great West. i've once again picked up my talks with HR again to see if there's any chance the hospital will be added to the network.

if not... well i need to put things into perspective. God's blessing in this: our stock is near the 52-week high and the trading window opens on monday. time to sell some stock to pay for the $$$$$'s. also, even though the list of specialists is small, the fact that one is 20 mintues away from me is a great blessing. and i have greater hope than i ever have in the past two years that i may finally have a working knee again next year.

The Lord gave, and the Lord has taken away; may the name of the Lord be praised.
-Job 1:21


Every blessing You pour out
I'll turn back to praise
When the darkness closes in, Lord
Still I will say

Blessed be the name of the Lord
Blessed be Your name
Blessed be the name of the Lord
Blessed be Your glorious name

1 comment:

Anonymous said...

aw man ... that is a bummer. but im glad you found dr4 and he sounds a lot better than dr2 (lame-o). will be praying for you karen!